Organization
PEDERSEN FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL A PEDERSEN D.O. (SOLE MEMBER)
(856) 630-5506
Entity
Organization
Contact information
Practice address
1450 E CHESTNUT AVE, BUILDING 3, SUITE D, VINELAND, NJ 08361-8467
(856) 692-0050
(856) 692-0081
Mailing address
2743 BETHPAGE CT, VINELAND, NJ 08361-7741
(856) 630-5506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB09405100
NJ
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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